Universal Livability: A Dream for Tomorrow, A Plan for Today

Goal 3: Health Care and Health Promotion Access

Improve access to California's health care and health promotion systems by applying the Social Model of Disability and creating change in the physical and social environments.

Rationale:

Without "access" there is no health care. According to the Institutes of Medicine (IOM), access is "the timely use of personal health services to achieve the best possible health outcomes." The issue of access is relevant to all health services, from simple preventive measures and primary care to chronic care and rehabilitation. Application of the social model requires system building to increase health industry awareness of issues unique to people with disabilities. It further requires the health industry to adopt the belief that responsive and reasonable access is not a "special accommodation" but the norm. This belief would hold that all people will benefit from an environment free of physical, attitudinal, and communication barriers, as required by the federal ADA and other disability-related civil rights and regulations. c

Recommendations for Action:

3.1 Create a Health Care and Health Promotion Access Task Force with diverse member and organization representation, to identify strategies to create changes that will result in an environment free of physical, attitudinal, information, and communication barriers. This will include the following steps:

Timeframe: One year.

Cost: Could be initiated with existing resources; but would require approximately $10,000 to support the task force's meetings and related costs, and $50,000 to contract out to develop the incentives program.

3.2 ODH, in collaboration with the aforementioned task force, will enlist the commitment of pertinent medical boards to work with people with disabilities' constituencies to develop social and physical access standards tailored to meet the diverse needs of people with disabilities.

Timeframe: Three to five years.

Cost: Indeterminate.

3.3 ODH, in collaboration with the task force, will enlist the commitment of health care plans and provider certification entities to address the social aspects of access. With guidance from people with disabilities' constituencies, the task force will stimulate the development of quality standards for care managers when working with people with disabilities to develop plans of primary and preventive care. An example might be requiring a dialog with the consumer and among care planning disciplines when there are secondary conditions related to disabilities. Another might be to require informed consumer choice of treatment modalities.

Timeframe: Three to five years.

Cost: Indeterminate.

3.4 ODH in collaboration with partners d will conduct a statewide assessment to identify which of California's health care professional, allied health, and public health schools and programs have incorporated, or wish to incorporate training on practical solutions to the preventive health care issues and concerns articulated by people with disabilities. ODH, in collaboration with the task force, will acknowledge model plans and best practices in providing increased access to both information and services (e.g., Cal Optima and Inland Empire Health Program).

Timeframe: One to two years for assessment; three to five years for promotion of model programs.

Cost: Indeterminate.

3.5 ODH, in collaboration with partners d, will identify and evaluate effective training curricula, methodologies, and tools that focus on improving access by modifying the physical and social environments, and articulating the role and value of client and family empowerment, and improving response to the issues and concerns related to preventive health care needs expressed by people with disabilities and their families/circles of support.

Timeframe: One to two years.

Cost: Costs will range from approximately $50,000 to $75,000.

3.6 Based on findings in Recommendations 3.4 and 3.5, ODH in collaboration with the task force will create a proposal to present to educational organizations and institutions, such as medical schools, public health schools, therapy, nurse practitioner, and physician assistant programs, with state level support and incentives for adoption. This proposal will utilize North Carolina Office on Disability and Health's Publication: Removing Barriers to Health Care: A Guide for Health Professionals and focus on meeting educational needs from a Social Model of Disability perspective, emphasizing communication, quality of life, culture, risk factors, secondary conditions, alternative or adaptive techniques and protocols for clinical care, ADA compliance, and community resources. This action will include the following steps:

Timeframe: Three to five years.

Cost: At a minimum, would cost $600,000 total ($200,000 per project) if contracted out, to develop and test model training program in three different environments.

3.7 ODH, in collaboration with the Department's Cancer Detection Section and the Radiological Health Branch and BHAWD, will support the expansion, implementation, and evaluation of the California Mammography Accessibility Project.

Timeframe: Three to five years.

Cost: Planning could be initiated with existing resources. Indeterminate additional resources would be needed for evaluation and expansion.

  1. Beyond the ADA, other disability-related civil rights laws and regulations may include, but not be limited to: Language Access Laws such as Title VI Civil Rights Act of 1964; Executive Order 13166, Year 2000; KOPP Act, California Health and Safety Code Section 1259.
  2. Partners are people with disabilities, other DHS offices, such as Medi-Cal Managed Care and external partners, such a local health departments, medical associations, therapy associations, health care organizations and facilities, disability training schools/centers, local service entities, and providers.